1821286394 NPI number — DR. TOM M KAO D.C., APN

Table of content: DR. TOM M KAO D.C., APN (NPI 1821286394)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821286394 NPI number — DR. TOM M KAO D.C., APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAO
Provider First Name:
TOM
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C., APN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KAO-CHEN
Provider Other First Name:
TOM
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C., APN
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1821286394
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1006 4TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FULTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61252-1778
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-589-4616
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1006 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FULTON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61252-1778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-589-4616
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  A182619 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 209031480 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: A05807 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: 038007086 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1119974 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 38007086 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 350043559 . This is a "RAILROAD PROVIDER NUMBER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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